By Dr Ananya Mandal, MD
The number of babies delivered by Cesarean section (C-section) has risen over the past few decades.
Sixty percent of the babies delivered worldwide are born in low income countries and it is estimated that every year, 0.8 – 3.2 million additional C-sections are needed in these countries.
Furthermore, in middle and high income countries, 4.0 - 6.2 million additional C-sections are performed every year. These numbers are based on World Health Organization data on mode of delivery across 137 countries worldwide.
According to reports, in populations where the proportion of C-sections performed exceeds 15%, the procedure provides no significant benefit to mothers and babies.
However, for improved maternal outcomes, a C-section rate of 5% has been shown to be beneficial and for improved neonatal health, a rate of between 5% and 10% has been shown to be beneficial.
On the other hand, many reports suggest that an optimal number of C-sections cannot be determined and applied worldwide, as the figures change based on maximum maternal and neonatal health outcomes, population, availability of health and medical resources and personal and societal conditions.
The rise in C-section rates has been attributed to the rise in elective C-section rates worldwide.
Data suggest that, increasingly, doctors as well as mothers are opting for planned C-sections, despite the absence of any medical indication for the surgery.
From the doctor’s point of view, elective C-section can mean avoiding a lengthy labor and birth at inconvenient hours as well as monetary benefits, factors that have been criticized as reasons for choosing C-section as a mode of delivery.
A higher educational status, and higher socioeconomic status are other factors associated with an increased rate of elective C-section.
Reasons that influence the decision to opt for C-section include fear of pain, pelvic floor tears and incontinence later in life.
Reviewed by Sally Robertson, BSc
Last Updated: Jun 2, 2014